Ankylosing Spondylitis & Uveitis: An Ophthalmologist’s Perspective

Close Coordination of Care

First-line treatment for uveitis typically includes topical or injectable corticosteroids, but the severity of disease and frequency of recurrence will dictate if additional treatments are needed. These treatments may include oral corticosteroids, methotrexate, mycophenolate mofetil and, if necessary, the addition of biologic treatments, such as tumor necrosis factor inhibitors, anti-interleukin 6 agents, calcineurin inhibitors and B cell depleting agents, such as rituximab. Close coordination of care is needed between ophthalmologists and rheumatologists to effectively treat the disease, monitor for medication side effects and long-term adverse effects, and ensure patients feel supported with regard to all manifestations of their systemic disease.

Even as some patients will experience more significant joint than eye symptoms over the course of their disease, others may have refractory uveitis despite quiescence of their musculoskeletal symptoms, thus communication between providers is imperative. Collaboration between practitioners in ophthalmology and rheumatology is needed now more than ever.⁶ 

The future has the potential to be quite bright for these patients, but only if the channels of communication are kept open and rheumatologists and ophthalmologists alike remain clear-eyed about the importance of recognizing and treating uveitis and its underlying causes. 

Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his MD. He is currently in practice with Arthritis, Rheumatic & Back Disease Associates, New Jersey.

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